Intraperitoneal focal fat infarction
A 30 year old man presented with right upper quadrant pain and raised inflammatory markers but normal liver function tests. An ultrasound examination was unremarkable so he went to have a CT.
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There is an oval shaped fat density structure lying adjacent to the falciform ligament and away from the gall bladder. It has an enhancing margin with mild stranding of the fat around it, and a central vessel. The vessels leading into this lesion look twisted on the sagittal image. The colon and liver look normal.
The findings are in keeping with infarction of a fatty appendage of the falciform ligament, an entity falling within the umbrella term of "intraperitoneal focal fat infarction" or IFFI. Other and more common types of IFFI include epiploic appendagitis and omental infarction. The diagnosis is important to make accurately as management is usually conservative. CT is the key diagnostic tool as it excludes other more serious pathology such as visceral perforation.